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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100086

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary MargaretCrout Sex Female

Date of Birth June 13, 1923 Place of Birth InversideCounty of Inverness

Name of Father Joseph Crout MAIDEN NAME of Mother Jessie MacLellan

Were the Parents married at the time of the Birth? Yes

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father Krakrow, Poland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Margaret Mary Scott Address of Applicant 67 Mountjoy St. North, Timmins, Ontario Date February 12, 2003

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary MargaretCrout

Born at Inverside in the County of Inverness

That Mary MargaretCrout Whose Birth is sought to be registered was

born at Inverside Inverness County on June 13, 1923

My knowledge of the fact and date of such Birth is based on the following Circumstances:

Certificate of Birth and Baptism and Marriage Certificate

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